It’s hard to predict when a tipping point will occur but once it happens, everything changes.

For example, peremptory airline behavior toward passengers — over booking flights, bumping passengers — has been going on for decades, but everything changed when a United Airlines dragged a passenger down the aisle, bloodying him along the way, in an effort to get back to business as usual. The issue rose to public consciousness in a way that it never had before, prompting wholesale review of airline procedures, not to mention a large payout to the injured passenger.

Lactation consultants didn’t intend to lie to Landon’s mother; they just told her the same lies they tell themselves.

Similarly, peremptory treatment of mothers by lactation consultants — ignoring their concerns about starving babies, in particular — has been going on for decades, but everything changed when Jillian Johnson shared the story of her son Landon’s death from dehydration due to insufficient breastmilk (If I Had Given Him Just One Bottle, He Would Still Be Alive). The issue rose to public consciousness in a way that it never had before, prompting new attention and hopefully a wholesale review of relentless effort to promote breastfeeding.

Landon cried. And cried. All the time. He cried unless he was on the breast and I began to nurse him continuously. The nurses would come in and swaddle him in warm blankets to help get him to sleep. And when I asked them why he was always on my breast, I was told it was because he was “cluster feeding.” I recalled learning all about that in the classes I had taken, and being a first time mom, I trusted my doctors and nurses to help me through this – even more so since I was pretty heavily medicated from my emergency c-section and this was my first baby…

So we took him home … not knowing that after less than 12 hours home with us, he would have gone into cardiac arrest caused by dehydration…

Landon died years ago and his story remained a private tragedy. Then the Fed Is Best Foundation was created by Christie Castillo-Hegyi, MD and Jody Seagrave-Daly, RN, IBCLC precisely to prevent such tragedies. Jillian felt that she could finally tell Landon’s story to medical professionals who understood, as opposed to lactation consultants who proverbially dragged her down the aisle, bloodying her along the way, in an effort to get back to business as usual.

Landon’s story has appeared in countless newspapers and blogs, in People Magazine and today it has reached television on the show The Doctors. Here is a deeply moving clip:

How could this have happened?

It happened because lactation consultants lie — first and foremost to themselves and each other, but most importantly to parents — insisting that breastfeeding is perfect and problems are rare. Regardless of the age, size and temperament of the baby, many lactation consultants claim that his mothers breasts ALWAYS make enough milk to fully nourish him and that ANY supplementation of breastmilk with formula destroys the breastfeeding relationship. Why? Because women were “designed” to breastfeed. But the truth is that breastfeeding, like any natural process, has a natural failure rate and complications are common.

It’s like insisting that nearsightedness is impossible because eyes are “designed” to see or claiming miscarriage is rare because women’s bodies are “designed” to produce babies. The truth is that 30% of Americans are nearsighted and the natural rate of miscarriage is 20%. Therefore, it should not be surprising that up to 15% of first time mothers (as Jillian was) won’t produce enough breastmilk to fully support a baby in the first few days.

This should not be news to anyone since across large swathes of the world, women offer pre-lacteal feeds in the first few days after birth, such as sugar water, teas and even honey, to their babies. Prelacteal feeding is practiced from Africa to Southeast Asia, to Central and South America, suggesting that a variety of peoples independently believed it to be necessary.

Not surprisingly, pre-lacteal feeds led to illness since they were often made with contaminated water. Lactation consultants looked at the phenomenon and drew the wrong conclusion. They decided that it was the process of supplementing in the first few days that was harmful, rather than the reality that it was the specific supplements that were harmful. It apparently never occurred to them to wonder why millions of women around the world and across the generations had come to the conclusion that colostrum was simply not enough.

Lactation consultants promulgated a variety of rules, embodied in the Baby Friendly Hospital Initiative, that are based on their belief, unsupported by scientific evidence, that every woman can make enough breastmilk and that offering anything other than the breast (formula, a pacifier) will destroy the breastfeeding relationship.

The scientific evidence actually shows the opposite: judicious formula supplementation actually increases the odds of extended breastfeeding and pacifiers not only don’t interfere with breastfeeding, they actually prevent SIDS.

Many lactation consultants lie to themselves and each other about the high rate of insufficient breastmilk and the high and rising rate of breastfeeding complications like dehydration, low blood sugar, permanent brain injury and even death. Their answer to any and all breastfeeding problems is “breastfeed harder.”

How can they ignore that harm that they are causing? They have conjured an all purpose excuse for breastfeeding difficulties, “lack of support.” Since they insist that breastfeeding is perfect, it must be mothers who are lazy or who aren’t being supported that are at fault.

It’s as if “vision consultants” suddenly started telling women that they couldn’t be nearsighted because their eyes were “designed” to see and therefore nearsightedness is rare. It’s as if they withheld glasses and contact lenses on the theory that if women just “looked harder” or got more “vision support,” all but an unfortunate few would have 20/20 vision.

No doubt the lactation consultants who told Landon’s mother he was doing fine while he was actually dying before their eyes believed what they were saying. That is what they were taught and that is what they continually tell each other. They didn’t intend to lie to Landon’s mother; they just told her the same lies they told themselves. Landon died as a result.

Worst of all, when presented with the evidence of Landon’s death, they are fabricating new lies. Some of the lies — such as the lie that Landon’s mother accidentally suffocated him — are extraordinarily ugly. The new lies speak to the desperation of lactational consultants and lactivists to continue believing their old lies that breastfeeding complications are rare.

Nothing will bring Landon back. Nothing will assuage his parents’ heartbreak. But we can hope that the story of his easily preventable death will serve as a tipping point so lactation consultants can’t go back to business as usual.

“I’d had an emergency c-section that I’d had to be sedated for because they needed to do it now, so I was loopy as all fuck and not actually all the way conscious. I kept randomly falling asleep for 2-3 minute intervals.
Through my haze of drugs I don’t actually remember if this was a lactation consultant or just a really pushy nurse, but somebody decided that I needed to nurse my son.

I repeated “No, I can’t, I’m not awake,” and “I’m not actually conscious, I can’t do this,” as they insistently placed him in my arms. And they replied, “You either need to breast feed him, or you need to bottle feed him. Do I need to get you some formula?”

“I can’t, I’m not awake.”

The next thing I remember- and I was still holding a baby during all of this, was someone placing a bottle in my hand, my looking at it, and then passing out again.

Who are all these fucking idiots giving exhausted people babies to hold?”

Yup, would they walk up to ANY other patient who had been up all night, or just gone through surgery (appendectomy, gall bladder, hysterectomy) or who was recovering from a procedure(say 2 tears and an long episiotomy because of vacuum extraction which means LOTs of stitches) and just hand them a baby and insist they feed it?? WTF is wrong with everyone!?

Jules B

But the all-encompassing sacrifice of one’s mental/physical/emotional self must start the second the baby arrives doncha know?? (Actually, the second you are pregnant – or maybe even before pregnancy, #sarcasm-obviously

KeeperOfTheBooks

One of the more awesome nurses I had after DS’s birth was, once she got started, raging on the subject of expecting all new moms to be solely responsible for the care of their newborns. She pointed out–and I agreed 110%–that a) no hospital would ever hand a newborn to a guy who had just had major surgery a couple hours before and say “take care of her,” and b) that at her previous hospital in another part of the state, that while the rooms had 4+ moms each as it was a county hospital, they STILL didn’t expect the moms to not send babies to the nursery!

Gæst

I mean, hell. After I had my appendix out the nurses had to wake me every couple of hours to check my temp and give me a suppository and they *apologized* for disturbing me. They sure didn’t give me a baby (of course, it was general anesthesia and not an epidural so, sure, that’s different. But come on. Post-surgery people shouldn’t be expected to care for other people.)

NinjaMama

I’ve been watching Call The Midwife (which should be viewed as a 5 series cautionary tale and model of reasonably responsible midwifery) and when I see the amount of support that was routine in the NHS in the freaking 1950s, I am horrified at how little support mothers are given after birth these days.

When I think back to being 4 weeks post-partum, my mother gone back to my home country and my husband back at work, and being alone 4 weeks out from major surgery with a tiny human…less was expected of me 4 weeks after a complicated appendectomy I had five years before…it beggars belief that this BFHI bullshit is meant to jive with the ‘village’ bullshit these same people spout on about.

The nurses at my hospital with my daughter took her to the nursery the first 3 nights. I couldn’t have managed on my own, that’s for sure.

Cody

I was a doula for a client who had a similar thing happen. I knew that the mom wanted to breastfeed because of previous conversations with her, so it was on my to-do list already. But she had just come out of surgery and we were in recovery. Dad was holding baby and mom was going in and out of sleep. The nurse had come in immediately after she got wheeled in and pressured her to try and latch the baby immediately. She was shaky and not feeling well. The nurse left again and I said it’s okay, don’t fight the sleep (or the shakes), you’ve been through a lot. If you want to wait to try and feed, that’s fine. The nurse came in two more times to try and get her to start breastfeeding in the next few minutes. Well, mom fell in to a deeper sleep and when the nurse came back I told her we’d wait to feed until mom had had some sleep. I’m not really supposed to speak up like that, but my goodness. Giving the woman half an hour of sleep and the chance to collect herself is not going to hurt.

AnnaPDE

Actually I think that was exactly the point of having a doula there. Someone firmly on the side of mum/dad/baby, but with enough distance to keep their wits about them after delivery and all and have the energy and composure to fend off pushy people, including medical personnel.
I didn’t have any need for support during the birth itself — scheduled C-section, great OB whom I trust 100%, not much to do or decide for me. In contrast, afterwards it would have been great to have someone who understands Fed is Best, in order to tell the nurses to shut up and get some damn formula (like I should have), instead of trying to argue with them and end up uselessly crying with a screaming baby in my arm.

FEDUP MD

I had something very similar happen after waking up from general anesthesia from emergency c-section.

I’m a doctor and a pediatric sub specialist too. Yet no one would listen to me when I was saying I was too drugged to safely hold the baby without dropping him on his head as I kept going in and out.

My husband ended up holding the baby in one arm and my breast in the other as I was only semiconscious.

I’m not sure what would have happened if he hadn’t been there.

Rebecca

Something similar happened to me. I had a c section, was on whatever amazing pain killers plus benadryl because I was itchy, and so I was totally out of it. I woke up to a nurse holding my baby to my boob and trying to get him to latch. I think I just went back to sleep. It was crazy.

no longer drinking the kool-ai

Best LC I know will also be the first one to say to a mom that she doesn’t have to breastfeed. She was certified the first year the exam was given and has always said the most important thing is for the baby to be fed. She is great at what she does, and although she would like to have every mother to have a great breastfeeding relationship with her baby, she also knows that some women will not have adequate mammary tissue to produce enough milk, that some women, especially sexual abuse survivors, cannot tolerate the sensation of breastfeeding, and for others breastfeeding just will not work with the life they need to live. The baby’s nutrition and well being must come first.
Sadly, she is the exception, and she is very dismayed by the newer LCs who don’t believe as she does.

Merrie

I attended a breastfeeding support group led by an outpatient LC at one of our local hospitals. She has always been refreshingly direct and not pro-breast at any cost; she makes it clear at meetings that formula is a valid choice and she doesn’t want anybody to be making comments or judging someone who is feeding formula.

Then there’s the one time I attended an LLL meeting, where a member (and self-identified aspiring leader) made multiple negative comments about formula and the leaders didn’t rein her in… never went back. I EBFed, as it happens, but I don’t see any point in the kind of comments she was making.

Oana Ghimpu

I’ve seen a couple of these lactation ‘consultants’ (I find the term infuriating as in the UK it implies very high qualifications). They kept going on and on and on how well my baby latches and completely brushed away my concerns as I kept explaining I previously had breast reduction surgery so it’s unlikely I could breast feed. They either did not know what that surgery entails or did not care. We had to be re-admitted a day after discharge as my daughter lost over 10% of her body weight. We finally started giving her formula (to this day I cannot fanthom how come the pressure about breastfeeding got to me as frankly I didn’t really wanted to in the first place) and she finally slept. Thankfully there were no major complications.
For some reason they sent yet another lactation consultant to see me – this old hag who again ignored the reason why I couldn’t breasfeed (milk cannot come out, milk ducts completely severed dooh) and put me on a harrowing schedule of pumping for 15 minutes after each feed. Do you want to know how much milk was coming out? 2 fucking mls. After taking domperidone, etc. I went through this ordeal for weeks when I finally came into my senses and stopped. I am still angry tho.

Empress of the Iguana People

Oh good god. You should be irate! (I was going to say pissed, but my british mystery habit tells me that’s a word for drunk on your side of the Atlantic) Okay, -I- didn’t until fairly recently, but my degree’s in history and education. LC’s really ought to know this stuff

Christina Maxwell

Pissed = pissed off, on this side of the Atlantic. And yes, Oana you should be very pissed off indeed!

StephanieA

I’ve been looking over the PROBIT study. I know it’s been mentioned on here, but do the higher IQ levels of breastfed babies in the study seem reliable?

Empress of the Iguana People

by a couple points. As in my ff’d spouse might have had 129 or 130 instead of 127.

An important point in that article that is overshadowed by the other stuff is that increased control for confounders leads to reducing the observed effect. This is always a concern, because it begs the question of, are there any confounders left unaccounted for?

In order to conclude it is right, you have to assert that you have accounted for everything. In a messy sociological study like this, how can anyone say that? But that’s what lactivists need to assert to even justify their 3 IQ benefit – that they’ve accounted for EVERYTHING!

It’s very concerning. You can’t put much stock in effects that are reduced when you increase controls, even if there are some residuals left over.

And as Young CC Prof notes above, there is the additional problem that when the confounders are big and the effect is small, even granting that there is an effect, the confounders are far more important. Instead of forcing poor people to breastfeed, get them out of poverty. That will have a big impact on IQs.

Roadstergal

I truly do think that confounders remained in the discordant sibling study. There are reasons one was BF and one was FF, and the discordance _might_ be for completely health- and situation-neutral reasons, but doesn’t have to be. And the bias will always be towards BF.

You can’t get around the fact that breastfeeding in the developed world is associated with ‘things going ok,’ overall. You can’t breastfeed if you’re working multiple shitty jobs, you can’t breastfeed if mom has no option but to work, you can’t breastfeed if the kid has some underlying health issue that affects latch and suck, you can’t breastfeed if mom has some underlying health issue that affects supply or quality – etc.

The Bofa on the Sofa

And I leave it with my open question, that I have not had a satisfactory answer for: has any study of breastfeeding ever controlled for daycare attendance?

Kids at daycare are more likely to have formula. They are also more likely to get sick. I don’t know about other stuff, but it’s out there.

BeatriceC

In an n=1 study, confounders can certainly be present among sibling groups. My first and second were born to a married couple. My third was born to a single mother. My husband left me shortly after I got pregnant with the youngest. My economic situation was drastically different with him than with the others as well, primarily having to do with that newly acquired single mother status.

David N. Andrews MEd, CPSE

A couple of points overall on an IQ test is not a signiificant difference. One a single subtest, yes. Over the whole test – not even close to significant.

Empress of the Iguana People

THat was my point.

David N. Andrews MEd, CPSE

Yes, and I was providing a psychologist’s input in support of what you said.

Roadstergal

As a biomarkers person, I always want to see the inter-assay and inter-operator variability before I take a few points difference as a real outcome. :p

Heidi_storage

As a nonscientist, I agree. I’ve read that IQ results are not super stable, which makes sense given the variability of results for pretty much all other tests.

David N. Andrews MEd, CPSE

I’m a psychologist by training. I can tell you that what you heard about IQ scores not being super-stable is correct. They have some extent of stability – which makes IQ tests useful – but they are not like the standard metre or the standard kilogramme or whatever. Obviously – we cannot expect them to be … but this does have some implications when trying to use them to justify some particular practice.

What surprises me is that psychologists will do such tests in studies like that if they don’t get to write up the material relating to what the test results actually mean.

for example, if there’s a mean difference between breast-fed and formula-fed children that’s less than one standard deviation (15 IQ points on a Wechsler), then the difference is not deemed significant and the finding is supportive of the null hypothesis more than it is supportive of the alternative hypothesis. In science, we have to be forced to reject the null hypothesis, and 0 – 14 IQ points’ difference between two conditions won’t do that. You do right to agree with Roadstergal. I also agree.

Heidi_storage

Thanks for the explanation.

David N. Andrews MEd, CPSE

You’re welcome. 🙂

Heidi_storage

I’ve also wondered about the “clinical significance” of such a difference. Suppose that it were rock-solid established that there really was a difference of a few points between two groups, even accounting for test-to-test variability and all that jazz. What are the implications for such a difference? Don’t other traits of personality, opportunities, etc affect what one is able to do in life?

David N. Andrews MEd, CPSE

Well, this is the good bit: a statistically significant difference is 1sd, and a clinically significant difference is 2sd. So a difference between scores or between means of groups of scores that failed to be statistically significant would automatically fail to be clinically significant. So, the 2-3 points difference reported in these studies would be clinically insignificant.

There would therefore be no implications at all for that sort of difference.

As for the influence of personality and opportunities, etc., on how well one is able to do in life.. largely, if one has a reasonable IQ, the availability of opportunities will have a large effect. But this one isn’t that simple of an issue. I’ll have to check a couple of my old psych-testing textbooks and see what there is there that could shed light on this.

swbarnes2

The discordant sibling study looked at intelligence tests and saw nothing. This Irish study also looked intelligence tests, and found nothing.

The PROBIT results that were blinded were the weakest findings. So all of that together…breastfeeding has to be having at most a very very very small influence. If that.

Young CC Prof

I don’t know, it’s possible there is some real effect on the order of 3 points.

I do know that for ANY study that made any reasonable attempt to control for economic confounders, the effect of family socioeconomic status was much larger than the effect of feeding method. So all the bullies telling working-class women to quit so they can nurse are just plain wrong.

somethingobscure

LCs need to start listening to moms, pediatricians, and most importantly, babies. Breastfeeding support is great, but the life of the baby and mother must take priority.

I was discouraged from giving my babies formula those early days by the hospital LC, but luckily my pediatrician insisted on it, my babies survived, and then I breastfed them both successfully for about a year Each. Supplementing did NOT hurt my breastfeeding relationship with my children. They need to stop telling moms that it will. It is an outright lie and it is dangerous.

AnnaPDE

Yes, this.
LCs, nurses, midwives, breastfeeding advocates: Listen to what the baby is trying to tell you. They’re pretty loud and clear about it while they still have the energy to scream. Stop the gaslighting and idiotic rationalisations that go against the laws of physics and biology.

I recently noticed, just a propos a friend getting a cat: A newborn weighs about the same as a smallish grown cat. If anyone told you that they’re feeding their cat only a few teaspoonfuls of fluids and food every day, you’d call animal welfare on them for deliberately starving the poor kitty. So who can seriously pretend that a human of the same size and weight needs orders of magnitude less food and fluids?!

StephanieJR

It’s a sad thought that my rabbit is probably better fed than some EBF babies…

Michele

and possibly some formula fed ones too. I remember hearing of a baby dying because mom was not mixing the formula correctly. She was using too much water. But lets just blame it all on breastfeeding right? smh

StephanieJR

Fuck off.

Sarah

Well, depending on where this case occurred, it’s quite possible that the woman wasn’t given appropriate advice about mixing formula safely as part of some misguided breastfeeding drive. Happened to me, though luckily I knew already.

Michele

Are you seriously comparing the nutritional needs of a cat to the needs of a newborn infant? lol We are totally different species and require totally different levels of proteins, fat etc. The caloric content of human milk is exactly what a newborn needs.

Heidi

What does that have to do with not feeding your baby enough? The milk I made I believe was the right ratios, but I totally lacked in the quantity department. So believe it or not, I fed him human baby formula, not kitten formula. But do go on and deny that some women don’t make enough, make up dangerous lies like breastfeed babies are fine to lose over 7% of their birth weight, that their stomachs remain tiny for weeks, and then act all indignant when your lies harm an infant and you get called out for it.

Amy Tuteur, MD

So why is there no correlation between breastfeeding rates and infant health?

AnnaPDE

Michele, please read again for comprehension. This is about the amount of food received.

Mammals’ cells work pretty similarly, so while the kind of food they need and its exact amount varies (growing baby with big brain on human milk vs adult cat on solids and water), such a comparison is perfectly usable for sense-checking that the amount is in the right ball park. Especially so when it comes to fluid intake.
Which, in the case of a few teaspoonfuls, it is not.

Let me state that again, just to recap: A few teaspoonfuls’ worth of fluids per day, be it water, breastmilk, or magical unicorn tears, is not enough hydration for a baby. And obviously also not enough nutrition.
Stop pretending it is.

Jane Doe

I work with LC’s. I must admit I read the article pretty quickly but the author has a chip on her shoulder with lactation consultants. The article is BS in my humble opinion. Breastfeeding moms are taught to PAY ATTENTION TO WET DIAPERS. HOW MANY??? It’s easy to not count wet diapers but it’s critical to an infant. Even a formula fed infant. Moms have to pay attention to what’s going
in AND what is coming out.

Amazed

Yeah, why should you pay attention to how baby died because of LCs incompetent advice? After all, you’re here to rush to LCs defense. Shame on you.

Oh, and don’t use the word “humble” in the same sentence as “my opinion”. There’s nothing humble in your opinions. Just lots of arrogance.

That’s why babies starve and die. Because you read the evidence pretty quickly before starting to spit fire in LCs’ defence. Let’s not forget what’s the important thing here, right? Namely, defend the torturing and murdering incompetents.

You make me sick with your skimming over the deadly details.

D/

You’re right here.

There is almost always behind-the-scenes LC discussion about each most recent Fed is Best or other ‘fear-mongering’ story. The overwhelming majority of what I’ve seen focuses on defensive claims of “we all know this” and “we all do (or would never do) that” and all of the other reassurances of why that could never happen to “us” or at “our” hospital or in “my” practice. Less often speculation will shift to dismissing the story as untrue, and infrequently blame is somehow even shifted to the family.

Honestly, I understand the need to WANT to not believe. These sort of accounts are terrible. Not wanting to believe something, though, doesn’t make it an impossibility. In fact, by failing to recognize that every one of those why-that-could-never-happen rationalizations actually increases the risk of unsafe care by discouraging vigilance, we make harm more possible.

What I don’t understand the seeming inability of so much of the professional lactation community to move past that natural human tendency of protective disbelief. I do not understand the lack of both curiosity and the professional responsibility to WANT to dig into the details of every medical error and learn what breakdownS in safe care happened and why. There is no other way to provide **intentionally** safer care in the future.

Unfortunately as long as our introspections into how our breastfeeding advocacy contributes to tragic stories like Landon’s end with claiming “we all know this” and “none of us would do that” AND as long as we are focusing on breastmilk exclusivity as the measurable quality metric of breastfeeding support, I’m afraid there is every reason to expect such tragedies to be repeated. As much as I hate to say it, I am not very optimistic about change coming soon or easily in either respect.

KeeperOfTheBooks

Thank you so much for your input! I always love your posts here. 🙂

D/

You’re very welcome and always so sweet 🙂 I’ve been mostly “away” for a few months and not able to keep up here. Hope things are going well for you and yours.

KeeperOfTheBooks

I haven’t been here much either, but wanted to say “hi!”
They are, thanks, and I hope the same is true for you. 🙂

D/

Thankfully, things are finally looking better here, but the last few months have been pretty relentless for my family.

Just to update, you may have missed my post back in December of my granddaughter’s anencephaly. We’ve all had an understandably difficult time with her death, especially my daughter who also lost her job in the aftermath of it all. Just as all of that barely settled, an uninsured driver hit me and totaled the only decent vehicle that we had. And then as the icing on my little crapcake, influenza ran through half of my household and Mr D/ ended up in ICU over it. Scared me half to death! Not knowing how he was going to do, and my other daughter and granddaughter so very sick at home too 🙁

I’m hoping our unfortunate run is over for a while and things will ease back toward something normal. It’s been nice to feel like I finally have the energy to hang out over here again … even though I’m mostly just sitting quiet in the corner, as usual.

Leave it to you to notice and manage to drag a smile outta me 🙂

Heidi

According to all the breastfeeding websites, babies need to have less wet diapers than what other medical websites claim. In fact, a couple of weeks ago, we specifically had an LC who claimed only one within the first 24 hours. But what is considered a true wet diaper? They don’t weigh them in the hospital! And before you throw us moms under the bus and blame us for staff imcompetence, how are we to know​ how heavy a diaper should be to truly count? For the record, I considered the father of my baby just as responsible as me to “pay attention to what’s going in and coming out.”

momofone

Oh, ok. So keeping the baby alive is just the mom’s job.

Charybdis

Bullshit. It is easier, certainly, for formula feeding mothers to gauge what their newborn is eating, because you can SEE THROUGH THE BOTTLE. Or, mix up 2 ounces and feed. If the baby inhales the 2 ounces, they can offer more. Easy peasy. No questions, no concerns.

Breastfeeders, not so much. Because the LC’s/IBCLC’s/some nurses/some doctors insist that a newborn only needs 1-2 milliliters to be satisfied. “Colostrum is more concentrated than mature milk, so the baby doesn’t need as much.” And the belly ball insanity…”your newborn’s stomach is only the size of a marble! They don’t need much to be satisfied!”

Really, the entire lactivist community seems to engage in all sorts of mental gymnastics to insist that newborns are not ever being harmed by EBF mandates of the BFHI. They are spinning things as “normal” that are clearly not: brick dust in the diapers, a sure sign of dehydration, is “normal”. 7 +% weight loss- totally normal. In fact, babies NEED to lose weight because they are somehow bloated like Violet Beauregard from Willy Wonka because mom had an IV during labor. High bilirubin levels and jaundice? Totes normal for breastfeeding babies. Why subject the baby to numerous needle sticks to measure bilirubin levels when a couple of ounces of formula is non-invasive? Preferring an IV to help hydrate a newborn instead of offering non-invasive formula? Second night syndrome…all babies are fussy and inconsolable the second night after being born. LC’s who will fudge the diaper count so that it seems as if everything is copacetic (I’ll count this one twice because it is *really* heavy), Not telling the mother if the baby is losing weight because it might “discourage” her or she might be tempted to supplement with formula.

The problem is that when mothers do have concerns about their baby getting enough via breastfeeding, their concerns are pooh-poohed and minimized via lactivist rhetoric:: babies only need scant milliliters to be satisfied, dehydration is normal, brick dust is normal, high levels of jaundice is normal, excessive weight loss is normal, they just need to breastfeed more, more, more, harder, harder and harder. It is so vanishingly rare that a woman doesn’t make enough breastmilk that we won’t even discuss it. Even if a woman has IGT, PCOS or other things that can inhibit milk production, they are not discussed, addressed or even mentioned as a possible impediment to breastfeeding. Because it might discourage her breastfeeding and that is not to be allowed.

There are plenty of women who have had shambolic early breastfeeding experiences. Some persevered with it and were
successful, some persevered, hated it, and quit. Some got fed up with being the only person who could feed the baby, some suffered from PPD and stopped, some are sexual assault survivors and find breastfeeding triggering, some need medication that is not safe for breastfeeding and some just Don’t. Want. To.

We have found each other and found our voices and are being heard. And believed. And we are pushing back against the Lactivist Brigade and calling out their bullshit. I’d be inclined to listen to our voices and experiences and learn from them. Learn
some humility, some listening skills, some empathy and sympathy, some respect for bodily autonomy and basic human decency.

Empress of the Iguana People

While no where near as bad as the real kind of course, for me breastfeeding became something with assault-ish undertones. I shiver and feel kind of sick at the thought of bfing. It was just too much to have my body at the constant demand of someone else. Dem still isn’t allowed to touch me there because I don’t react well to it, even if we are canoodling. Used to enjoy it a lot, but now, only once in a very great while. I don’t blame my child for doing what comes naturally, especially since I’m the one who foolishly chose to continue, but well, there’s a reason why my younger child has formula

Empress of the Iguana People

Of course she has a chip on her shoulder. She’s learned from a lot of her regulars that there are a bunch of fecking horrible LCs out there. The one I saw in the hospital was the most arrogant know-it-all of any health care person I’ve ever dealt with. My son’s male ped was far more helpful for us to learn this breastfeeding thing, too. The LC at the ob’s office was okay personally, but she was so busy telling us to do 10 minutes on a side and not hearing the part where I had oversupply and it took the kid a feeding and a half to empty one side! He’d never get any hind milk if I switch sides every 10 minutes.

somethingobscure

STOP LYING FOR GOODNESS SAKE. I was NOT taught this by my LC. The nurses monitored it and they encouraged me to supplement with formula, but even when there weren’t any wet diapers in a while, the LC actually flat out said let’s wait because it could hurt the breastfeeding relationship. Thank god my pediatrician disagreed and I gave my son some formula. Oh and by the way, after my milk fully came in I breastfed for nearly a year. Stop spreading your lies and bs.

swbarnes2

Lack of wet diapers is a late indication of dehydration. If you notice a lack of wet diapers, your baby has been in trouble for hours already.

StephanieA

Yep. We are supposed to adhere to the one diaper the first day, 2 diapers the second day, etc. I witnessed a nurse reassure a mother that her baby’s two wet diapers in 24 hours was plenty and was on track. That baby had seizures later that night and a glucose of 30.

Azuran

I just love how the LC are all saying that when the mother had IV fluids the baby can lose more weight because he is all swollen with fluids, but they don’t adjust the number of wet diaper accordingly and will still claim that 1 slightly yet diaper is ok.
Where is all that additional water going?

Empress of the Iguana People

evaporating without converting to liquid first like snow will do sometimes?

MayonnaiseJane

Sublimating. Also why ice cubes shrink in the freezer.

Empress of the Iguana People

that’s the word

Sue

That’s another reason why I love this blog – people who science AND people who language.

Charybdis

Same place socks do in the laundry.
Or all babies are Tardises (Tardii?)- they’re bigger on the inside than on the outside.

Roadstergal

It’s Schroedinger’s baby. It’s both excessively swollen and totally normal – just as long as the pediatrician doesn’t look.

Gæst

Well, in my case most of it came out as sweat three days later…

SporkParade

If it’s BS, then why were obvious signs of dehydration in my baby ignored by the hospital staff, who were very proud of their training in breastfeeding support? When I proposed giving a bottle, I was either bullied for lack of commitment to breastfeeding or gaslighted and told rapid weight loss, lack of wet diapers, neon orange urine, and deep lethargy were normal. Even when the situation got so bad that supplementation was critical as opposed to mere advisable (we’re talking over 10% weight loss in 36 hours), the nurse had to make me “read between the lines.” When I asked for information about supplementing in a way that would preserve my supply, I was told she wasn’t allowed to discuss it with me because, “My job is to tell you to breastfeed.”

Turns out that I make large, hungry babies who require more colostrum than I can provide, especially since my milk doesn’t come in fully until day 5. But, if I were to ask the local popular IBCLC and LLL leader, I’ve been harming my babies by supplementing until my milk comes in instead of letting them go hungry and me go bananas.

Young CC Prof

A child is dead, and your problem is that the author said something mean. Might want to rethink your priorities there.

OttawaAlison

You know what I could have really used in my postpartum haze – to know what is considered a wet diaper felt like in terms of what would the minimum weight be. My daughter did pee, she just wasn’t peeing remotely enough. When I finally started supplementing her, I realized just how under-weight her diapers had been.
That’s the reality, the LCs don’t always tell you to watch out for, how much output there should be for example. I’m an educated woman with an educated spouse and we were unintentionally starving our daughter.

The other issue is we do get gaslit by people telling us our experiences with low-supply didn’t happen and that we are lying to make ourselves feel better. A lot of people in the Lactation community dismiss moms like me and our experiences.

Jules B

I only just realized reading your comment that after I started supplementing my daughter, I was like “Wow! I wonder why I am suddenly changing so many diapers??” I distinctly remember thinking that at the time – not fully realizing that before, when I was (trying) to breastfeed exclusively, I was changing her less because she was peeing less. Of course, as a first-time Mom who had never before changed a diaper and was told “as long as she is having wet diapers, all is well,” I never even thought to look at how MUCH pee was in the diaper. (Which is hard with disposables sometimes anyway). And no one ever thought to mention that to me, either. Another LC fail.

OttawaAlison

I’m guessing it’s of a common problem than people realize. I’ve since learned it should feel at least as heavy as 1 ounce / 30 ml of water (simple thing to do is just feel a diaper with that much liquid) every few hours, Poop should be plentiful too, she pooped some, but maybe about 1/10th the amount she should have been. I was monitoring the quantity of wet/soiled diapers, just not the quality.

I had looked after older babies , just not newborns.

Young CC Prof

Very few first-time mothers have any experience with newborns, and newborns are unlike older babies in some very important ways. Which is why we need newborn nurses, to guide parents and to watch for trouble, not just to promote breastfeeding.

KeeperOfTheBooks

Which leads me to thinking that, y’know, it would be REALLY easy for a nurse to, as part of new parent education, pour a measured amount of water into a newborn diaper and say “your kid should be producing a diaper every X hours that feels kind of like this.”

Gæst

My NICU made us weight the diapers at first. Not a bad idea, but the first time I changed my daughter she started peeing as soon as I opened the diaper and there I was, frantically trying to “catch” it so the diaper weight wouldn’t be off…

cookiebaker

There’s a difference between wet diapers and WET diapers. I cloth diapered mine and my youngest was rapidly losing weight, yet had many diapers with a tiny amount of moisture, qualifying as wet. However, once we began supplementing her, the diapers became saturated and I realized the level of WET I was supposed to be seeing. Diaper output is subjective and not reliable.

Sue

In and out fluids are not easy to assess in the first few days of a newborn’s life – especially for first time mothers.

AnnaPDE

It’s not that simple. Babies can dirty a bunch of diapers without proper input — that’s how they lose weight and water! When the baby stops peeing, that’s already a sign of dehydration, i.e. already too late.
In contrast, weighing the baby and checking if they’re still hungry after breastfeeds (by offering a top up) is a simple way of tracking how they’re doing while things are still ok.

There’s absolutely no point in sticking to some marker that only tells you when there’s already a serious problem instead of nipping it in the bud.

NinjaMama

My daughter lost 25% of her birthweight while still have wet diapers. The only one spouting BS is you.

Young CC Prof

I want to thank Jillian for having the courage to come forward.

Loss parents (under any circumstances) are often subjected to the most horrifying harassment when they speak out, but it’s just victim-blaming, just people trying to reassure themselves that such things only happen to children of BAD parents. In fact, there are no guarantees for any of us.

In this case, she’s also taking abuse from lactation consultants who, every single day, treat mothers and babies the way the hospital staff treated her, with false reassurances, normalizing problems and sweeping issues under the rug. They cannot face the cognitive dissonance of knowing that such actions killed a child, so they seize on any possible excuse to dismiss the story.

But Jillian Johnson isn’t alone. There are thousands of women whose babies suffered harm from insufficient intake due to bad care and bad care protocols. For years, shame and isolation kept us silent, but we’ve found one another, we’ve found a voice, and we aren’t going away until changes are made.

There were a lot of first-time moms of nearly term preemies who had really small amounts of colostrum (like under 100mL as a day total) for 3-5 days after their kids were born then had their milk ramp up over days 5-14.

Meanwhile, the NICU nurses who were not surprised by that at all gave the babies formula. The babies routinely drank 20mL 8x a day which is 160mL. Several babies ate 40-50mL which is 400mL per day!

Also, the “babies are better at getting milk out of breasts than a pump” is crap. Some babies may be – if they are good sucklers and the mom is experienced – but some are pretty damn clueless even with an experienced mom. I got really good at coaxing milk out with a pump using massage and compression ; Spawn has many talents, but breast feeding isn’t one of his.

If we have another one, we’re bringing premixed formula to the hospital. If anyone has problems with that, they can go talk to the NICU staff.

DaisyGrrl

Some of these LCs appear to have forgotten something key about patients. Patients usually seek assistance if something is going wrong. I go to the optometrist when I have problems seeing. The majority of my optometrist’s patients likely also have problems seeing. That doesn’t mean the majority of people have vision problems. It means that people experiencing problems seek help from professionals who can diagnose and fix the problem.

While it’s true that most women probably have adequate supply, these are not the women who will be seeking the services of an LC. It is the subset of the population who has difficulty that will seek assistance. If an LC is based in the hospital and checks every new mother, she is still likely spending more time with the mothers having difficulty (or she should be). So an LC’s experience of women and breastfeeding should be skewed toward the portion of women and babies who do not successfully establish breastfeeding.

Why is this so hard for them to grasp?

Amy

I think it’s part of the larger culture among the “natural family living” crowd that idealizes “the norm.” Think of the way they talk about medical care and health in general– doctors just want to give you drugs and surgery, doctors think everything is an illness or problem instead of just a “variation of normal,” etc etc.

Young CC Prof

Part of it is because they are radically underestimating the true incidence of low supply, and thus think it must be rare even among women who are struggling. I mean, a neurologist seeing patients by referral is going to see more people with brain cancer than a primary care doc, but even in the neurologist’s office, brain cancer is uncommon.

In fact, while most women can make enough, low supply is relatively common, with our best estimates at 5-15% of the population. (Our best estimates are lousy due to a lack of proper research.) But many LCs are taught numbers much lower than that, which messes up their probability guesstimates and diagnostics all kinds of ways.

The Bofa on the Sofa

But many LCs are taught numbers much lower than that,

I’m not sure this is a fair characterization. Do you really think LCs are “taught numbers” of women who have insufficient supply?

I think it’s not that they are “taught numbers” that are lower than 5 – 15%, it’s more that they deny that the patients in front of them have that problem.

fiftyfifty1

It’s both denial about the patient in front of them AND that they get taught lower numbers. I have heard them say that true biological low supply is less than 2% and that the 5% is only if women don’t feed the baby on demand.

Who?

Low supply is a zebra in lactivist world.

Empress of the Iguana People

Or a przewalski’s horse. Even rarer. And rather inbred.

Eater of Worlds

A bunch are now radioactive to boot.

Young CC Prof

That is exactly what I’m trying to say. LCs are trained to believe that “true” low supply is a zebra, and thus they are reluctant to believe any of their individual patients have it.

Steph858

Believing something to be a zebra is no excuse to dismiss the possibility that a patient has it in the face of all evidence pointing towards it. A GP might not jump to ‘brain tumour’ as the cause of every patient who complains of a headache, but when a patient also suffers from vomiting, seizures, memory loss …

Roadstergal

Exactly. They don’t think it’s a zebra, they think it’s a unicorn. Something that other people believe in but is never actually there in front of them.

Patriciabconley

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Dr Kitty

GPs are also trained to refer anything that *might* be cancer as if it is cancer.

Getting a 10% positive diagnosis off suspected cancer referral is about right.
Any higher and you aren’t referring enough, any lower and you refer too much.

LCs/ MWs and paediatricians shouldn’t want every blood glucose, bill and U&E they check to be abnormal- they should want most of the babies they order further investigations on to be fine. If they only pick up abnormals, they aren’t investigating enough.

MI Dawn

OMG. I didn’t know they were claiming suffocation caused Landon’s death. What horrible people they are! And every story I read like this only confirms more that if/when my children have children, they will be supported in feeding their baby, and encouraged to make sure the baby is FED not starved to death, even if that means giving a bottle if needed.

Empress of the Iguana People

Aye, they seem to think that shaken baby isn’t real, but would even blame that because it would be preferable to the Holy Boob being imperfect.

Bugsy

It’s similar to the anti-vaxxer stance that shaken baby isn’t real, but is caused by the vaccines. (And if the baby is too young for the 2-month vaccines, then it was caused by Vit K or the vaccines that mom had during pregnancy.)

J.

Shake baby syndrome has been over-diagnosed though. The New York Times had an article about it a few years ago. The situation I remember best is a baby that died by suddenly pushing his high chair back from the table. The hospital didn’t believe the parents. The autopsy said Shaken Baby Syndrome and the parents were arrested. Turns out, the parents had been fortunate enough to be hosting five judges at dinner who witnessed the incident.

I’d find the link, but I’m rushing out the door.

J.

Couldn’t resist: found the link and I got some details wrong. It was the ophthalmologist who diagnosed shaken baby. There were seven people playing cards in the room and it doesn’t mention their professions (though another article may have). The account is halfway down this article: http://www.nytimes.com/2011/02/06/magazine/06baby-t.html

Sorry about my errors of memory, I blame my newly diagnosed MS. Now I’m off to listen to music for an hour (in the MRI). Thank goodness those things are magnets rather than radiation, or I’d be glowing!

Empress of the Iguana People

Oh my…

lawyer jane

Yep. Shaken baby is certainly real, in that abusers shake babies, and that can cause brain damage. But it is falsely diagnosed with severe consequences. Medical practitioners had been trained to basically take certain injury findings as CONCLUSIVE proof that the child was abused … despite the fact that there’s no other evidence that the child was abused (and ignoring other things that could have caused the brain injury, like a clotting disorder, prematurity, etc.) This happened to a client of mine. It was harrowing. They got the kids back but it was awful. I can’t imagine anything worse than having your baby suffer a traumatic neurological injury, and then having to fend off accusations that YOU did it at the same time you are freaking out about your child.

lawyer jane

In fact come to think about it … the “public health” campaign about Shaken Baby kind of resembles BFHI in some ways. You take a nugget of truth (babies are shaken and injured), simplify it beyond all measure, and then require that medical personal apply it is an extremely literal way with no thought to unintended consequences.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
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